Providence Surgery Centers LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

PENDING Issued in AK

Legal business name

PROVIDENCE SURGERY CENTERS LLC

Doing business as

Creekside Surgical Center

Practice address

3831 Piper St. Suite S-110
Anchorage, AK 99508

Phone

(907) 339-7800

Fax

(315) 571-9944

NPI assigned

Jun 10, 2010

Last updated

Jun 10, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Colleen M Bridge

Title

Secretary, Board of Managers

Phone

(907) 212-3035

Specialties & licenses 1

Addresses

Other names 1

• Creekside Surgical Center Doing business as

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Listed as

Providence Surgery Centers LLCCCN 02C0001011

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Providence Health & Services - Washington

  dba Providence Health Park Pharmacy

  • Community/Retail Pharmacy
  • Anchorage, AK
  • NPI 1821271271

  Member Of

  NPD member

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jason Sweeney, MD

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1568565927
  NPD
• Richard W Garner, M.D.

  • Orthopaedic Surgery Physician
  • Anchorage, AK
  • NPI 1396773727
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276128000000",
    "number": "1710207998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 233889",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995233889",
            "telephone_number": "907-212-3035",
            "fax_number": "315-571-9944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3831 PIPER ST. SUITE S-110",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99508",
            "telephone_number": "907-339-7800",
            "fax_number": "315-571-9944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE SURGERY CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-10",
        "last_updated": "2010-06-10",
        "status": "A",
        "authorized_official_last_name": "BRIDGE",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SECRETARY, BOARD OF MANAGERS",
        "authorized_official_telephone_number": "907-212-3035"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AK",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creekside Surgical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Providence Health & Services-Washington (Providence Medical Group Alaska)
• Providence Health & Services-Washington (Providence Horizon House)
• Providence Health System Washington (Providence Apothecary)
• Providence Imaging Center
• Providence Imaging Center
• Ellen Michelle Provost, DO
• Kimberly Pruetting, LMT
• Alexis Victoria Pruitt
• Ellen Pryor, OTRL
• Psychiatric and Addiction Recovery Center of Alaska, LLC

• Ambulatory Surgical Clinic/Center in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Ambulatory Surgical Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.